Prexella vs TherapyNotes

The short answer

Choose TherapyNotes if most of your revenue comes from in-network insurance, you want claims, ERAs and eligibility checks inside your EHR, and you value its unlimited non-clinical users and phone support.

Choose Prexella if most of your clients pay privately or out of network, you want your own brand and domain on everything clients see, you plan to add clinicians without adding seat fees, and you want booking, prepaid packages and marketing in the same system.

Prexella vs TherapyNotes: 12 criteria side by side

TherapyNotes plan prices are from its official pricing article and add-ons from its pricing page, both verified 10/10/2026. Where a feature is not on those pages, the table says so.

Criterion	Prexella	TherapyNotes
Pricing model	One flat fee for the practice	Solo $69/mo; Group $79/mo for the first clinician
Additional clinicians	Included in the flat fee	$50/month each; non-clinical users unlimited
Cost for 3 clinicians	Flat fee, quoted on a demo	From $179/month, before add-ons and usage fees
Free trial	Live demo with your own services	30-day free trial
Insurance claims	Claims prepared for your biller's clearinghouse	Electronic claims, ERAs and eligibility at 14¢ each
Online booking with payment	Yes, card checkout on your domain	Not listed on their pricing page
Client portal	Yes, on your domain	"Custom client portal"
White-label / own domain	Yes	Not listed on their pricing page
Superbills	One click, with CPT, ICD-10, NPI and EIN	Not listed on their pricing page
Telehealth	Scheduling and join links; video in your own BAA tool	Basic video free; premium $15/clinician
Reminders	Email reminders included	Email free; text or voice 14¢ each
Marketing tools	Built-in marketing suite and newsletter	Free TherapySearch directory profile

Pricing for a three-clinician practice

TherapyNotes is priced per clinician with usage fees on top, so the total depends on how you work. Here is the list-price math for one owner and two associates.

TherapyNotes Group.

Line	Monthly
Group plan, first clinician	$79
2 additional clinicians at $50	$100
Subtotal	$179
Optional: premium telehealth, 3 × $15	$45
Optional: TherapyFuel AI, 3 × $40	$120
With premium telehealth and AI	$344

That is $2,148 a year for the base plan and $4,128 a year with premium telehealth and AI, at list prices verified 10/10/2026. Usage fees come on top. As an illustration only, a practice sending 240 text reminders and 240 electronic claims in a month would add 480 × 14¢, or $67.20, that month. Card processing is 3.1% + 30¢ per payment, and e-prescribing is $65 per prescriber a month if you need it.

Prexella. One flat fee covers the practice whether you have one clinician or five, quoted for your practice on a demo call. Reminder emails and superbills are included rather than metered. Prexella has no AI scribe and no built-in video, so if you would use TherapyFuel or premium telehealth, factor in what you would pay elsewhere for those. A solo clinician on TherapyNotes Solo at $69 a month who bills insurance may well pay less with TherapyNotes.

What clients see in each system

Booking. Prexella's client-facing booking page sits on your own domain: a new client chooses a session, picks telehealth or in office, takes an open time and pays by card in one flow, and every slot is checked on the server so two clients can never take the same hour. TherapyNotes' pricing page does not list online booking with payment; it lists a custom client portal.

Paperwork. In Prexella, a new client goes straight from payment into creating their portal account, where your intake form, informed consent, telehealth consent and privacy notice wait to be signed with an ESIGN and UETA audit trail: consent statement, typed name, drawn signature, timestamp, IP address and browser.

Between sessions. Prexella's portal lets clients message you, complete PHQ-9 and GAD-7 check-ins, keep a journal, work through workbooks and buy more session credits, all under your practice's name.

Money. Out-of-network clients get a superbill generated in one click from their completed sessions. Clients who prefer to prepay buy session credits. In TherapyNotes, the money workflow centers on claims, ERAs and card processing at 3.1% + 30¢.

What a practice owner's week looks like

Monday: in Prexella, the dashboard shows the week's sessions, clients whose session credits are running low and forms still unsigned. Credit-low reminders and package reminders go to clients automatically, so nobody has to write those emails. In TherapyNotes, Monday more often starts with the claims queue: rejections, ERAs to post and eligibility to check, which is exactly what it is built for.

During the week: Prexella emails every client a reminder the day before their session, with the video link for telehealth clients, at no per-message cost. Recurring clients keep their weekly slot without being rebooked. TherapyNotes sends email reminders free and text or voice reminders at 14 cents each.

Month end: in Prexella, out-of-network clients get superbills in one click each, income is reviewed in Finances, and the marketing suite shows which channels brought new clients in. In TherapyNotes, month end centers on claims reconciliation and reporting; if most of your clients are in-network, that is a strength rather than a weakness.

When you hire: adding a clinician in TherapyNotes adds $50 a month; adding a biller or scheduler costs nothing. In Prexella, neither changes the flat fee.

Where Prexella wins

1. Your brand, not a vendor's

Prexella is white-label: your practice name and domain appear on the booking page, client portal and every email and superbill. TherapyNotes lists a custom client portal, but custom branding on your own domain is not listed on their pricing page. For a private-pay practice, every client touchpoint is a chance to build your own name.

2. One price as the team grows, with fewer meters running

TherapyNotes adds $50 a month for every clinician and charges per text reminder and per claim. Prexella is one flat fee, and reminders and superbills are included. For a practice hiring associates, that makes software cost easy to forecast.

3. Built for private pay and growth

Prexella's online booking takes card payment up front, prepaid session credits remove month-end invoicing, and the marketing suite keeps the Meta and Google ad results you record, video scripts and client newsletters next to the calendar they are meant to fill. TherapyNotes' marketing is a free directory profile.

Where TherapyNotes wins

1. Insurance billing built in

TherapyNotes submits electronic claims, receives ERAs and runs eligibility checks inside the EHR at 14 cents each, and its pricing positions it squarely at insurance-billing behavioral health. Prexella hands claims to your biller, who submits them through their own clearinghouse. If most of your revenue is in-network, TherapyNotes saves you a step and a vendor.

2. Clinical depth and video

TherapyNotes includes basic telehealth video and sells HD group video, an AI tool (TherapyFuel), e-prescribing and MIPS reporting. Prexella keeps session notes, e-signed intake forms and PHQ-9, GAD-7 and C-SSRS screenings, but has no AI notes, no e-prescribing and no built-in video.

3. Unlimited admin users and a self-serve trial

TherapyNotes lets you add unlimited non-clinical users (admins, schedulers, billers) at no cost and offers a 30-day free trial you can start today. Prexella is set up for you after a demo, which is quicker to get right but not instant.

Verdict

Prexella vs TherapyNotes is not a question of which is better overall. TherapyNotes is the stronger tool for in-network, insurance-heavy behavioral health practices, and its unlimited admin users make it practical for groups with billing staff. Prexella is the better fit for private-pay therapists, psychologists, counselors and coaches who want their own brand, a flat cost as they grow, and booking, prepaid packages and marketing in one system.

If you are weighing several options, TherapyNotes alternatives compares nine side by side, and Prexella vs SimplePractice covers the other common switch. Profession pages for psychologists and social workers cover billing codes and workflows in detail.

How to switch from TherapyNotes

1. Export your client list, documents and any reports TherapyNotes lets you download before you cancel. If you need continued read-only access to old charts, TherapyNotes lists a storage plan at $9 a month plus $3 per additional user.
2. Book a setup call. The Prexella team configures your services, fees, intake and consent forms, booking rules and branding.
3. Send new bookings to your Prexella booking page while existing appointments and open claims finish in TherapyNotes.
4. Cancel after one billing cycle, once final claims, invoices and superbills are out.

The full checklist is on how to switch to Prexella.